Provider Demographics
NPI:1811562069
Name:GEHRIS, BRANDON THOMAS (MD)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:THOMAS
Last Name:GEHRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13500 SKYLINE RD NE APT A4
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87123-2173
Mailing Address - Country:US
Mailing Address - Phone:240-538-2975
Mailing Address - Fax:
Practice Address - Street 1:915 CAMINO DE SALUD NE ALBUQUERQUE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-1501
Practice Address - Country:US
Practice Address - Phone:505-272-2321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-20
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2025-0328390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program